44 2 5 25 2005 2002 FDG-PET PET FDG-PET PET-CT PET positron 80 2 PET positron emission tomography 930 Warburg - FDG 2-deoxy-2-[ 8 F]fluoro- D-deoxy glucose FDG-6-2005 6 30 602-084 465 2FDG FDG-PET 2002 GlucoseFDGGlucose
Glucose Glucose FDG-PET CT MRI 3-iXCT
99 60 80 CT FDG-PET,08 97 7790 CT FDG FDG-PET FDG - 60 88 FDG-PET 8
FDG-PET 0 FDG FDG PET FDG FDG-PET FDG PET Glucose-6-phosphatase 4 5mm 2 FDG FDG FDG-PET
2 FDG 3 - ii FDG-PET PET PET 4 FDG-PET PET 5 PET CEA PET6 2 0mm retrospective PET FDG-PET 5.3
37 36 0 8 3 2 0 0 6 7 3 0 0 27 26 4 0 0 LN 274 0 5 52 LN 7435 3 2 LN 32 LN LN 99 38 6 LN:Lymph node PET 6 - ipet 6 - i i CT PET PETCT CTretrospective PET/CT PET CT PET CT PET/CTCT PET CT CT CT CT 6 PET CTPET/CT 7 FDG-PET 994 PET 80 PET 2004 PET 8 PETPET.35PET 0.92PET 8 PETPET PET
3050 75 3 PET PET PET 3PET 7 0 PET PET PET PET PET 0.92 PET 0.42.35 0 25 50 75 00
4 PET FDG-PET FDG-PET 6060 20 8 F 40mg/dL FDG-PET 4 0 Kubota K. From tumor biology to clinical PET: a review of positron emission tomography (PET) in oncology. Ann Nucl Med 200; 5: 47-486. 02 Hustinx R, Benard F, Alavi A. Whole-body FDG-PET imaging in the management of patients with cancer. Semin Nucl Med 2002; 32: 35-46. 03 Delbeke D, Martin WH. Metabolic imaging with FDG: a primer. Cancer J 2004; 0: 20-3. 04 Dewan NA, Shehan CJ, Reeb SD, et al. Likelihood of malignancy in a solitary pulmonary nodule: comparison of Bayesian analysis and relults of FDG-PET scan. Chest 997; 2: 46-422. 05 Gambhir SS, Czernin J, Schwimmer J, et al. A tabulated summary of the FDG-PET literature. J Nucl Med 200; 42: s-93s. 06 Nakamoto Y, Higashi T, Sakahara H. et al. Delayed 8 F-Fluoro-2-deoxy-D-glucose positron emission tomography scan for differentiation between malignant and benign lesions in the pancreas. Cancer 2000; 89: 2547-2554. 07 Yamane T, Daimaru O, Ito S, et al. Decreased 8F-FDG uptake day after initiation of chemotherapy for malignant lymphomas. J Nucl Med 2004; 45: 838-842. 08 Stroobants S, Goeminne J, Seegers M, et al. 8 FDG-Positron emission tomography for the early prediction of response in advanced soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer 2003; 39: 202-20. 09 Jerusalem G, Beguin Y, Fassotte MF, et al.
Whole-body positron emission tomography using 8 F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin's disease and non- Hodgkin's lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood 999; 94: 429-433. 0 PET FDG 2003; 23: 29-4. Bleeker-Rovers CP, de Kleijn EM, Corstens FH, et al. Clinical value of FDG PET in patients with fever of unknown origin and patients suspected of focal infection or inflammation. Eur J Nucl Med Mol Imaging 2004; 3: 29-37. 2 Higashi K, Ueda Y, Arisaka Y, et al. 8 F-FDG uptake as a biologic prognostic factor for recurrence in patients with surgically resected non-small cell lung cancer. J Nucl Med 2002; 43: 39-45. 3 Kent MS, Port JL, Altorki NK. Current state of imaging for lung cancer staging. Thorac Surg Clin 2004; 4: -3. 4 Kostakoglu L, Goldsmith SJ. 8 F-FDG PET evaluation of the response to therapy for lymphoma and for breast, lung, and colorectal carcinoma. J Nucl Med 2003; 44: 224-39. 5 Ishimori T, Patel PV, Wahl RL. Detection of unexpected additional primary malignancies with PET/CT. J Nucl Med 2005; 45: 752-757. 6 Cook GJ, Wegner EA, Fogelman I. Pitfalls and artifacts in 8 FDG PET and PET/CT oncologic imaging. Semin Nucl Med 2004: 34: 22-33. 7 Antoch G, Saoudi N, Kuehl H, et al. Accuracy of whole-body dual-modality fluorine-8-2- fluoro-2-deoxy-d-glucose positron emission tomography and computed tomography (FDG- PET/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol 2004; 22: 4357-4368. 8 Ide M, Suzuki Y. Is whole-body FDG-PET valuable for health screening? Eur J Nucl Med Mol Imaging 2005; 32: 339-34.
Clinical PET in Oncology Chio Okuyama Department of Radiology, Kyoto Prefectural University of Medicine Graduate School of Medical Science PET using 8 F-FDG has been successfully applied to the evaluation of malignant tumors. Diagnosis of cancer is based on the ability of 8 F-FDG to detect the foci of tumors with increased glycolysis. There are 2 major roles of the FDG-PET in oncology; the differential diagnosis whether a known lesion is malignant or benign, and the whole body survey for the initial staging and detecting the recurrences and metastases in the follow-up state. Today in Japan, FDG-PET is also widely used for cancer screening. Since FDG-PET is one method of the metabolic imaging, it frequently offers more accurate information than morphological imaging modalities, including CT and MRI, in depicting unexpected foci of metastases or recurrent tumors that have not yet become apparent, or are difficult to observe on CT or MRI scans. However, there are various inflammatory lesions, in which FDG accumulates, and such physiological accumulation often confuses the diagnosis. Furthermore, there are also many malignant lesions that do not show definite abnormal FDG accumulation because of low cell-membrane glucose transporter levels, low hexokinase activity, vacant cellularity, or other factors. Serum glucose and insulin levels also affect the FDG distribution in the tumor tissues. Image resolution of PET is inferior to that on CT, so small lesions measuring less than cm are frequently overlooked. The utilities and the pitfalls of FDG-PET that should be recognized when interpreting the imaging findings are described. : FDG-PET, Oncology, PET-CT, Cancer screening